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Breastfeeding week

From knowing what to eat, to dealing with breast pain or low milk supply, breastfeeding might not always be simple. This breastfeeding week, in order to make it easier on you, our expert has joined the community to answer any questions you might have. Ask our breastfeeding expert your questions here!

Is it normal to go beyond my expected due date?

Yes, it is very common. Global figures suggest that only about four per cent of babies are born on their exact due date.

Your due date is an estimate of the day that you will give birth, and is calculated as 40 weeks after the first day of your last period. Your doctor may update your due date following your ultrasound scans, which gives a more accurate picture of how far along in your pregnancy you are.

Most babies arrive between 37 weeks and 41 weeks of pregnancy, usually within a week either side of their expected due date. Twins and triplets tend to arrive before this time frame.

The average or median gestational age for Asian women is found to be 39 weeks. A prolonged pregnancy is defined as one that lasts longer than 42 weeks (294 days).

Many hospitals have a policy of inducing labour at or after 40 weeks, so it is difficult to give an exact figure for pregnancies which go beyond this time.

Does it matter if I go past my due date?

If you are only a few days past your due date, your doctor might not offer to induce your labour right away. However, a lot depends on your health and what your doctor feels is best for you. No doubt, by this stage it is likely that you are feeling a bit fed up with being pregnant.

Doctors do worry when pregnancies go on for several weeks past the due date. That is because a very small number of babies die unexpectedly while they are still inside the uterus (womb) after 42 weeks of pregnancy.

The number of babies who are stillborn or who die shortly after birth also gradually increases after 39 weeks. Even so, having a baby which is stillborn between 39 weeks and 42 weeks is very rare.

Doctors are not sure why the risk of loss increases as the weeks go by. They don't know whether it's to do with the length of pregnancy or the health of the mother or baby.

One Indian study has found that after 41 weeks and 4 days of pregnancy, there was an increased risk of meconium-stained waters (amniotic fluid).

This study also shows that perhaps after 41 weeks, your placenta may not work as well as it did previously. As a result, the supply of oxygen and nutrients to your baby may be reduced. The authors concluded that pregnancies should be monitored from 41 weeks and labour should be induced at 41 weeks and 4 days.

Induction before 41 weeks is not recommended by experts. This is because we do not have enough evidence about the benefits or any undesirable effects of inducing between 38 and 41 weeks. And there are no tests that you can do to tell you whether it would be better for your baby to have your labour induced.

There is some debate about the timing of induction, however. Some studies show that babies are healthier at birth and more likely to be born safe and well when hospitals induce labour at or before 42 weeks.

Other studies disagree and say that routinely inducing labour at this time makes little difference to babies' wellbeing if their mothers are healthy.

However, because Asian women are thought to have slightly shorter pregnancies, guidelines recommend inductions at about 41 weeks, if you haven't gone into labour before then and not any later.

How common is induction?

A recent survey suggests that the induction rate in Asia as a whole is 12.1 per cent. Induction without medical indication accounts for 3.6 per cent of births in India.

32.1 per cent of inductions in India are elective. But the rate varies depending on where you live.

What happens if I'm overdue?

If you haven't had your baby by the time you are 41 weeks pregnant, you will have to meet your doctor for an antenatal check-up.

If your pregnancy has been straightforward, you will probably be offered an induction after 41 weeks. The timing will vary according to your health, your doctor and the hospital policy.

Some doctors may offer an induction between seven days and 10 days after your due date, while others may offer after two weeks. It varies and the ideal time to induce labour in overdue mothers is still not known for sure.

Your doctor will:

Check that your due date is correct by confirming when you had your last period.

If a membrane sweep doesn't do the trick, your doctor will discuss with you the pros and cons of having your labour induced with hormones.

Your doctor will advise you on what's best for you and your baby and most certainly explain what would happen if nature is allowed to take its course. If you decide to go for an induction, you will be given a date to go to the hospital for it.

If the doctor decides to wait and not to have your labour induced, it is likely that you will go into labour on your own before 42 completed weeks (that is if your due date is based on an ultrasound scan which is more exact than based on your last menstrual period). Your baby is still very likely to be born safe and well at this stage.

What are my options?

If you have spoken to your doctor, but you are not sure about having an induction, you could ask for a day or two to consider it. Talk to your family members and friends who have had an induction. However, keep in mind that every pregnancy is different.

An alternative to induction is to have your pregnancy monitored every two to three days, to check that your baby is well. Your doctor will decide if this option is worth considering based on your health and the health of your baby.

You may be asked to get admitted at the hospital so your doctor can get a record of your baby's heartbeat on a Sonicaid (portable Doppler) or with the help of a cardiotocography (CTG) machine.

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